Organization
COLORWELL THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DEMETRIC L. PENTELTON LMHC (OWNER)
(716) 578-2563
Entity
Organization
Contact information
Practice address
2000 WINTON RD S OFC PARK, ROCHESTER, NY 14618-3970
(585) 340-7046
Mailing address
2000 WINTON RD S OFC PARK, ROCHESTER, NY 14618-3970
(585) 340-7046
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
11/09/2022
Last updated
11/09/2022
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